FDA Adverse Event Malfunction Summary report: N

T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY

MDR report key: 15786066 · Received November 13, 2022

Report

Report Number
3013756811-2022-126280
Event Type
Malfunction
Date Received
November 13, 2022
Date of Event
October 24, 2022
Report Date
November 13, 2022
Manufacturer
TANDEM DIABETES CARE
Product Code
QFG
PMA / PMN Number
K201214
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

NO PRODUCT WAS RETURNED FOR EVALUATION. SHOULD NEW RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PUMP TOUCH SCREEN WAS MISSING PIXELS. CUSTOMER¿S BLOOD GLUCOSE LEVEL RANGED FROM 180-199 MG/DL. THE CUSTOMER CONTINUED USING THE PUMP FOR INSULIN THERAPY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2757667 T:SLIM X2 INSULIN PUMP WITH CONTROL-IQ TECHNOLOGY ALTERNATE CONTROLLER ENABLED INFUSION PUMP QFG TANDEM DIABETES CARE 1002717

Patients

Seq Age Sex Outcome Treatment
1 51 YR Male